Smoking during pregnancy

Smoking during pregnancy is an important preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes. For more information, see Clinical commentary.

This indicator examines the number of all women who gave birth that reported smoking in the first 20 weeks of pregnancy and those who reported continuing to smoke after the first 20 weeks of pregnancy.

Key findings

  • The proportion of women smoking during the first 20 weeks of pregnancy is declining nationally (from 13% in 2011 to 8.8% in 2020) and in all states and territories.
  • In 2020, women were more likely to smoke if they gave birth in the NT (20%) than the ACT (5.2%).
  • Women younger than 20 were most likely to smoke and women in their 30s and 40s least likely across all years between 2011 and 2020.
  • A higher proportion of women living in Very remote areas or in the most disadvantaged areas reported smoking than mothers who lived in Major cities or the least disadvantaged areas.

The interactive data visualisation below presents data on smoking for all women giving birth in the first 20 weeks of pregnancy and for those who continued smoking after the first 20 weeks by selected maternal characteristics. Click the Data tables button to view the data between 2011 and 2020 and use the radio buttons to see how each characteristic has changed during this time.

Smoking in the first 20 weeks of pregnancy for all women giving birth, by state/territory and all Australia, 2011 to 2020.

The chart shows the proportion (%) of all women who gave birth who smoked in the first 20 weeks of pregnancy from 2011 to 2020. Data can be viewed for each state/territory of birth, and for all Australia. The proportion for all Australian mothers decreased from 13% in 2011 to 8.8% in 2020.

Another smoking indicator can be selected showing the proportion of all women who gave birth and reported smoking in the first 20 weeks of pregnancy who also reported smoking during pregnancy after twenty weeks. This proportion has increased from 2011 (71%) to 2020 (74%).

Clinical commentary

Women who smoke tobacco during pregnancy are more likely to experience pre-term birth, placental complications and perinatal death of their baby (WHO 2013). 

Babies of mothers who smoke during pregnancy are at increased risk of poor growth during pregnancy, particularly during the phase of rapid weight gain from 34 weeks of gestation onwards (Sirvinskiene et al. 2016). Sudden infant death syndrome, childhood diabetes and childhood obesity have been linked with exposure to tobacco during fetal development (Banderali et al. 2015; Flenady et al. 2018). Maternal smoking is associated with low birthweight, which in turn is associated with poor educational outcomes in early childhood, coronary heart disease, type 2 diabetes, and being overweight in adulthood (Guthridge et al. 2015; Lumley et al. 2009).

Smoking cessation during pregnancy is key in reducing the risk of complications during pregnancy and birth as well as reducing adverse health outcomes for the baby. Cessation at later stages of pregnancy will still improve health outcomes for the baby, including improved fetal growth (AIHW 2021; Miyazaki et al. 2015).

There are clear associations between smoking in pregnancy, age of the mother, remoteness of residence and disadvantage quintile evident in the results presented. Varying sociodemographic profiles of women who give birth in public and private hospitals needs to be taken into account when considering the higher rates of smoking in pregnancy for women giving birth in public hospitals.

Indicator specifications and data

Excel source data tables are available from the Data tab.

For more information, refer to Specifications and notes for analysis in the technical notes.